Permit CITY TIGARD PLUMBING PERMIT
I� DEVELOPMENT SERVICES PERMIT #: PLM2003 -00202
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/15/03
SITE ADDRESS: 13611 SW TRACY PL PARCEL: 2S104CD -10200
SUBDIVISION: HILLSHIRE ESTATES NO. 2 ZONING: R -7
BLOCK: LOT: 101 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of (2) sinks and (1) water closet for kitchen and bathroom remodel.
FEES
Owner:
Description Date Amount
CERBONE, ROBERT + DEBORAH
13611 SW TRACY PL [PLUMB] Permit Fee 5/15/03 $72.50
TIGARD, OR 97223 [TAX] 8% State Tax 5/15/03 $5.80
Total $78.30
Phone :
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 503 Rough -in Insp
Final Inspection
Reg #: MET 00002486
LIC 87906
PLM 34 -250PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Issued By: -' 4 / Permittee Signature: d7 / 97°A - / C'6} - 770 -
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
05/15/2003 14:08 5036916771 MODERN PLUMBING PAGE 01
05/I5/2dbr1f:56 Fa. 5035981960 CITY OF TIGARD a1004
• ' Building Fixtures E E VED FC)12 OFFICE I:SE ONLY D f Received . :.� • Earthing �ZDaZ
1 i err D viBi. - 5 - 1/S/ f ern itNo.:/ 1 00.3 -D
MAY 15 2003 Approval Sewer
City of Tigard Date/BV: _ PeindtNo -:
CITY OF TIG •■ P Review Other 13125 SW I3a1]tSiv 2 NG DI BUILDING eattnitNo.: - _ - -- '
Tigard, Oregon 97223 • Post-Review tend tN Um
Phone: 503 - 639 x71 lax; 503 ;- y; Case
,, � ,
Internet p, .ci. 01:•Ua 11,1-• 'j �' Contact Anis.: Soo 1 for
tea• ...! �- ..., t>a�cWt'al uInformation. 24 it Inspection Request 503 -639 -4175 Nart�tethod: 7/(r I Bapip
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. 4Ctl' Ion Qty � Tail! ,
Ki New C0126121u:tioll Demolition y , :. t,• d' (y irl i i a i -M e ti 111' 5¶' 4 t; 'rn{
Add{ �rsia'cati0�r t I � " : ;,„, . , f ,, , i' :r . a : =: r 4 , Y • ei;:w r:
Addition/alteration/ .lac�il y �" ' : ;,-,, .::., + .4 . 61 , - 7 1' c : . r •, :I •.fir i d� 349.20 -., ;I : . , :iii .i 7 '
1W i 7i-iC, ! .∎il '�i0•;Pv.y :-4 T ii. LI �s1'.:�ii %"4r 7 ; • r I bath
I/.1 1 & 2- Family dweliin . Ili CornmerciaUTndustria1 35o.oa
ill ' ccessory Building II Multi- Faa�mil .. h — 399 -00
0 D , ,,,, 45,00
• Master Builder car: `�'1a1.I; . , � - .. �
k ' w''::;. Imo: •
L, , J,r .�.•.� m . i. • �h ?..2'T1'4;: a ti ,,i4kd;'t1d�i,' 3! ^ � '' " �!N.'�� Ili ..k '' ^ 'U �. ;"�' 1�N ����.�� r'
Job site address: I.3 !Q I 1 5u} fir' ac 1 ct c'� [ , ,
Suite#: Bid_.! • I : ,., .: i, 16.60
- sot Name: C e c • ' Footirt�q dram (no, tine+3r R) : -
t�eoss sut/Aiaraiiuns to job site: _ ,_ -.. .. Manufoeeaorari hnme trti"lit ► t
manholes
Rain drain connector 16.60
• semi eawar - . linanr ft. la p : e 2
Subdivision: _ -- 1 Lot : Storni sewer Ito. linear - ; , ..: ,,
u
Tax J . service
I . I ' �Y'r: ,� ill! - 1 jT[.- II .. ", I�"1+I�i�l I'': �:.
..�..�...� - Cl rr: , 17 „J':: �. 6.60 i7 : rlb ' a • r• V•�� H.t. �a N. t. Absorption val
r'P�'(II� ' ti_a�:i ; ljl( ' s' Patte2 ” .
Bac1dow • revanter
'11 �� MI 16.
Clothes *Willa
IllillIMIIIIIM
�Dishwashcr ' puntaia
m• ,•:; • r , '• j' 'SLI; 1 _ J' L .:: Ii I:! . ). • f.i nectors/sump 6.60 - i
Name: - • Expansion tank • 11111 16.60 !
Fixture/sewer e..
Address: i w '�QC a L` Floordt�o/floarsintcAtub . � - -_ -
C:ItY /StateJZi ' : I a a • • 2z Garbage disposal 16.60 —
Phone: C.3 5 - Q Y300 ax: t• ... -
Hose bib
Na me: 4'rv CSCern P \..trw - . c (0 . - " . is' MI
Address: 1 t 1 L• . s OS + .= .'
City/State/Zip: I Tin iN, Cam• q1O(' heater - ., . .,. ��.> �
Phone: 5D3-4.09i- Q I in fo J Fax: . - q1-4 , , . , . NM {6,60
E-mail: • I � "13 DD . a 1 • • e r., co r'` 16.60
y c�� i _ ,iyr r7 n ails '' ' 7 .
�`; - Water c loset MI who co'
_:.. . Business Name: cy • •- ��
Business siune � 1 u m b + . 0 • Water heater
Md1e56:111 - a-cr S I n c +.) S ■ n 1 ) am incr.: -
�1� 9 a Other: : . * rr � . : : t
Ci /Statr°!Zi • : u . 1. ti �.'�..i: �:'a r ;y , ,
Fax:St& G,C7 • (. 7 "7J ---... - �iil
Fbtone:S03. tc►yCs _ ,'..
Plumb. Lic. #:34 ,2SOPti , " $ 5'0
CCB Lie. • $�90 �, . ,,, , , ,
Authorized Residential Stiff _e :°lo ofP- ..t 'ee`d
► b. • 41 te • . c. ..ca �` - TOTAL PERMIT FEE S : . 0
{plt tit ) g re Z sets otl Plans With isometric or
Mike This permit appliietttlOA =pins it' � perms[ $ not obtaiacd within riser diagram for pion ,
180 days after it Ate been aeeepted Is cottsplot� *Fee methodology set by Tri- County noUding Industry Service Board -
MDst &Wennit FOrftsPmPertnitApp.duc Ot #s
�r
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 AM V PM BUP
Location l '?J a' l( I - f� L'. - Suite 2 a:23- 7J2 "I
Contact Person x
Ph ( ) PLM2—C 3 - OXj7..C)
Contractor Re-el Ph ( ) X - 61(47 SWR
BUILDING Tenant/Owner ELC 3 - d �• 95-
Footing
Foundation EL
Ftg Drain
Access: r' S 91-C r ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors •
at Sheath/Shear
Int Sheath/Shear
Framing
Insulation
. Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
LOMB G
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains •
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot.=
a
I ti_ PART FAIL
— ANI
_ CAI,)
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
T FAIL
rIEHLIELT
Roug -In
UG/Slab
Low Voltage
Fi - Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
C1 PART FAIL
❑ Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 / / g / °5 Inspector T L5 - _ � Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL